<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-5057</journal-id>
<journal-title><![CDATA[Investigación en educación médica]]></journal-title>
<abbrev-journal-title><![CDATA[Investigación educ. médica]]></abbrev-journal-title>
<issn>2007-5057</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-50572025000300109</article-id>
<article-id pub-id-type="doi">10.22201/20075057e.2025.55.25725</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Horarios de Trabajo en las Residencias Médicas]]></article-title>
<article-title xml:lang="en"><![CDATA[Resident Work Hours in Mexico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sepúlveda Vildósola]]></surname>
<given-names><![CDATA[Ana Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Limón Rojas]]></surname>
<given-names><![CDATA[Ana Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional Autónoma de México Facultad de Medicina ]]></institution>
<addr-line><![CDATA[ Cd. Mx.]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional Autónoma de México Facultad de Medicina División de Estudios de Posgrado]]></institution>
<addr-line><![CDATA[ Cd. Mx.]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<volume>14</volume>
<numero>55</numero>
<fpage>109</fpage>
<lpage>115</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-50572025000300109&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-50572025000300109&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-50572025000300109&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Se examina la evolución de los horarios de trabajo en las residencias médicas mexicanas, un modelo nacido a mediados del siglo XX bajo la lógica de &#8220;aprendizaje por inmersión&#8221;. Durante décadas se normalizaron jornadas que superaban las 100 horas semanales y guardias de 36 horas continuas, prácticas justificadas por la exposición clínica intensiva, pero que derivaron en serios problemas de salud laboral, seguridad del paciente y calidad formativa. La ambigüedad normativa permitió esquemas heterogéneos entre instituciones hasta la emisión de la NOM-001-SSA3-2012, que intentó regular la educación en salud sin fijar límites precisos a la carga horaria. Ante la evidencia sobre fatiga y los riesgos asociados, la actualización NOM-001-SSA-2023 delimita un máximo de 80 horas semanales y dos guardias por semana, e introduce el modelo rotatorio ABCD, que distribuye una guardia cada cuatro días y busca reducir la fatiga acumulada. El texto explora los efectos fisiológicos, cognitivos y de seguridad vinculados a la privación de sueño, incluyendo riesgos cardiovasculares, trastornos metabólicos, deterioro de la memoria y aumento de errores médicos. Se comparan experiencias internacionales: el límite de 80 horas del ACGME en EE. UU., las 48 horas de la directiva europea, el tope de 72 horas en Quebec y las recientes reformas japonesas para prevenir el kar&#333;shi. Asimismo, se describen modelos alternativos de turnos 12×12 y 24×24, sus beneficios y desafíos operativos. También se subraya la indefinición jurídica del residente, quien oscila entre la categoría de estudiante y trabajador, dificultando la protección laboral. Se propone una supervisión universitaria más estricta, adecuaciones presupuestales y un cambio cultural que priorice el bienestar del residente, la supervisión docente y la infraestructura de descanso. Se concluye que garantizar entornos dignos no solo mejora el aprendizaje, sino que es esencial para la seguridad del paciente y la calidad futura de la atención en salud.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: We trace the evolution of resident work hours in Mexico, a training model introduced in the mid-twentieth century based on total clinical immersion. For decades, shifts exceeding 100 hours per week and 36-hour on-call duties were standard, defended as necessary for clinical exposure but ultimately raising serious concerns about occupational health, patient safety and educational quality. Regulatory ambiguity generated wide institutional variability until the 2012 standard NOM-001-SSA3, which addressed graduate medical education but set no explicit hourly limits. Responding to mounting evidence on fatigue and institutional pressure, NOM-001-SSA-2023 now caps duty hours at 80 per week, limits residents to two calls a week and introduces the ABCD rotating model, assigning one duty every four days to curb cumulative fatigue. The chapter reviews physiological and cognitive consequences of chronic sleep deprivation-cardiovascular risk, metabolic disorders, memory impairment-and its association with increased medical errors. International benchmarks are analysed: the 80-hour ACGME rule in the United States, Europe&#8217;s 48-hour Working Time Directive, Quebec&#8217;s 72-hour limit and Japan&#8217;s recent reforms aimed at preventing kar&#333;shi (death from overwork). Alternative shift structures such as 12×12 and 24×24 are discussed, highlighting benefits and operational challenges. The text underscores the ambiguous legal status of Mexican residents, straddling student and worker categories, which complicates full labour protection. It calls for tighter university oversight, adequate financing and a cultural shift that prioritises resident well-being, faculty supervision and proper rest facilities. The chapter concludes that dignified training environments are not merely a welfare issue; they are fundamental to patient safety and to the future quality of healthcare delivery.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Residencias médicas]]></kwd>
<kwd lng="es"><![CDATA[horarios laborales]]></kwd>
<kwd lng="es"><![CDATA[fatiga médica]]></kwd>
<kwd lng="es"><![CDATA[seguridad paciente]]></kwd>
<kwd lng="es"><![CDATA[bienestar residente]]></kwd>
<kwd lng="en"><![CDATA[Internship and Residency]]></kwd>
<kwd lng="en"><![CDATA[Work Schedule Tolerance]]></kwd>
<kwd lng="en"><![CDATA[Fatigue]]></kwd>
<kwd lng="en"><![CDATA[Patient Safety]]></kwd>
<kwd lng="en"><![CDATA[Occupational Health]]></kwd>
</kwd-group>
</article-meta>
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